Medical and Surgical Management of ~ocar~ia~ infarction
MARCUS A. DeWOOD, MD JULIE SPORES, CRNA ROBERT N. NOTSKE, FACG HENRY T. LANG, MD J. PAUL. SHIELDS, MD, FACC CARROLL S. SIMPSON, MD, FACC LLOYD W. RUDY, MD RONALD GRUNWALD, MD
From the Departments of Medicine and Surgery, Sacred Heart and Deaconess Medical Centers, Spokane, Washington. This study was supported in part by The Sacred Heart Medical Center Research Foundation and by a gift from the Spokane Eagles Lodge, Spokane, Washington. Manuscript received April 26, 1979: revised manuscript received Jut; 16, 1979, accepted July 78, 1979. Address for reprints: Marcus A. DeWood, MD, Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles. California 90048.
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The in-hospital and long-term mortality (18 to 56 months) of two groups of patients treated concurrently for acute transmural myocardial infarction are retrospectively compared. Group I (no. = 200) was given medical therapy, whereas Group II (no. = 187) underwent early coronary arterial bypass grafting. The groups were comparable in average age, incidence of previous myocardial infarctions, initial electrocardiographic findings (S-T segment elevation), area of electrocardiographic involvement, initial cardiac enzyme activity, coronary anatomy (when known) and Killip classes I to Ill on admission to the study. Significantly more patients in Group II were in Killip clinical class IV. In-hospital mortality was lower in Group II than in Group I without (5.8 versus 11.5 percent) and with (1.2 versus 9.3 percent [P
MARCUS A. DeWOOD, MD JULIE SPORES, CRNA ROBERT N. NOTSKE, FACG HENRY T. LANG, MD J. PAUL. SHIELDS, MD, FACC CARROLL S. SIMPSON, MD, FACC LLOYD W. RUDY, MD RONALD GRUNWALD, MD
From the Departments of Medicine and Surgery, Sacred Heart and Deaconess Medical Centers, Spokane, Washington. This study was supported in part by The Sacred Heart Medical Center Research Foundation and by a gift from the Spokane Eagles Lodge, Spokane, Washington. Manuscript received April 26, 1979: revised manuscript received Jut; 16, 1979, accepted July 78, 1979. Address for reprints: Marcus A. DeWood, MD, Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles. California 90048.
1356
The in-hospital and long-term mortality (18 to 56 months) of two groups of patients treated concurrently for acute transmural myocardial infarction are retrospectively compared. Group I (no. = 200) was given medical therapy, whereas Group II (no. = 187) underwent early coronary arterial bypass grafting. The groups were comparable in average age, incidence of previous myocardial infarctions, initial electrocardiographic findings (S-T segment elevation), area of electrocardiographic involvement, initial cardiac enzyme activity, coronary anatomy (when known) and Killip classes I to Ill on admission to the study. Significantly more patients in Group II were in Killip clinical class IV. In-hospital mortality was lower in Group II than in Group I without (5.8 versus 11.5 percent) and with (1.2 versus 9.3 percent [P
